2020 Volume 40 Issue 7 Pages 905-908
A 17–year–old female patient presented with acute abdomen and ileus, and based on the findings of abdominal CT, she was diagnosed as having a left paraduodenal hernia with jejunal clustering beneath the inferior mesenteric vein. She gave a previous history of two episodes of intestinal obstruction of unknown cause, with the condition improving spontaneously with just observation on both occasions. For the present condition, she underwent successful elective laparoscopic release of the jejunal invagination and direct closure of the hernia orifice. However, on POD7, she developed signs of bowel obstruction with vomiting and abdominal pain, and CT and a gastrointestinal series revealed limited jejunal stenosis with inflammatory edema. We diagnosed the patient as having postoperative bowel stenosis with inflammatory edema caused by the surgery. Therefore, in accordance with the treatment for panniculitis, we carefully elected to treat the patient with a steroid administered by intravenous injection, which resulted in prompt and dramatic recovery of the jejunal obstruction and the patient recovered and was discharged. Laparoscopic repair is a simple and useful procedure for left paraduodenal hernia, and we showed the usefulness of steroid therapy for postoperative inflammatory jejunal stenosis.
